Depression and anxiety symptoms are associated with white blood cell count and red cell distribution width: a sex-stratified analysis in a population-based study

Background: Depression and anxiety are two important mood disorders that are frequently associated with chronic diseases such as cardiovascular diseases (CVDs). Hyper-inflammation is related to both CVDs and psychiatric conditions such as depression and anxiety. Therefore, inflammation may partially explain the relationship between depression and cardiovascular disease. Objective: The objective of this study was to investigate the association between symptoms of depression/anxiety disorders and serum hs-CRP and inflammation linked conditions in a large Iranian population. Methods: Symptoms of depression and anxiety disorders and serum hs-CRP levels were measured in 9,759 participants (40% males and 60% females) enrolled in MASHAD study. Symptoms of depression and anxiety were evaluated with Beck Depression and Anxiety Inventories. According to the scores of depression and anxiety, individuals were categorized into four groups of no or minimal, low, moderate and severe categories. Results: The median serum hs-CRP concentration increased with increasing severity of depression and anxiety disorders. Male participants with severe depression had significantly higher levels of hs-CRP (p <0.001); however, this relationship was less marked among women (p = 0.04). Subjects with severe anxiety also had significantly higher levels of hs-CRP (p <0.001). Moreover, women with severe depression and anxiety had higher BMI. There was also a positive association between current smoking habit and depression/anxiety disorders. Conclusion: Depression and anxiety disorders are associated with elevated levels of hs-CRP, particularly among men. There were also a significant positive association between depression/anxiety disorders and inflammation linked conditions such as smoking and obesity; however, in the case of obesity this association was only present in women.